The 4 incurable STIs you need to know about
Sexually transmitted infections (STIs) include a group of diseases that are transmitted through sexual contact. These conditions can lead to mild to severe complications, including itching, rashes, and infertility. A major issue with STIs is that many people initially show no symptoms, which means the infection can easily be passed on without being noticed. Early detection is crucial, as some sexually transmitted diseases cannot be cured and people who become infected may have to live with the condition for the rest of their lives. In this article, you will learn what STIs are, which STIs are incurable, how they are transmitted, what treatment options are available, and how you can protect yourself against them.
Table of Contents
- What are sexually transmitted infections (STIs)?
- An overview: the four incurable STIs
- How can you protect yourself against STIs?
- Summary
What are sexually transmitted infections (STIs)?
Sexually transmitted infections are diseases transmitted through sexual contact and can be caused by a variety of pathogens. There are more than 30 different pathogens, including bacteria, viruses, and parasites. The term sexually transmitted infections (STIs) refers specifically to the infections that cause these diseases.
In German, the abbreviation STI is used for both sexually transmitted diseases and infections. STIs can affect various parts of the body, including the genitals, anus, mouth, and skin. They can be transmitted through vaginal, anal, and oral sex as well as through close skin contact and blood (MedlinePlus, 2024).
Which sexually transmitted infections are curable and which are not?
Of the more than 30 possible pathogens that can cause sexually transmitted diseases, eight are responsible for the most common new infections. Four of these common STIs are caused by bacterial pathogens and are curable, meaning they can be fully treated with appropriate medications. The other four are viral infections that are not curable. The viruses that cause these conditions remain in the body for life but can, in most cases, be well controlled with medication (WHO, 2019).
The following table provides an overview of the most important curable and incurable STIs:
| Curable STIs | Incurable STIs |
|---|---|
| Chlamydia | Herpes simplex virus (HSV) |
| Gonorrhea | Hepatitis B (HBV) |
| Syphilis | Human immunodeficiency virus (HIV) |
| Trichomoniasis | Human papillomavirus (HPV) |
Source: WHO, 2019
Get tested for possible sexually transmitted infections
In the case of incurable sexually transmitted infections (STIs), there are often no visible symptoms depending on the stage of infection. However, the infection can still be transmitted even in the absence of symptoms. For this reason, safe sex practices and regular testing are crucial not only for your own health but also for the health of your sexual partners.
Homed-IQ's STI tests—including the HIV test, HPV-Test, and comprehensive STI test—offer the opportunity to discreetly test for all incurable STIs from home, without needing to visit a doctor.
An overview: the four incurable STIs
1 – Herpes
The herpes simplex virus (HSV) is a widespread viral infection that occurs in two main types: HSV-1 and HSV-2. HSV-1 is primarily responsible for oral herpes infections, which cause cold sores or blisters on and around the lips, while HSV-2 mainly affects the genital area. An estimated two-thirds of the global population under the age of 50 are infected with HSV-1, while about 11% of people aged 15 to 49 are infected with HSV-2 (WHO, 2023).
How is herpes transmitted?
Source: Cleveland Clinic, 2022
What are the main symptoms of herpes?
Symptoms of herpes include painful blisters or sores in the mouth, on the lips, genitals, or anal area, as well as itching or burning at the affected sites. Additional symptoms may include fever, fatigue, and swollen lymph nodes, especially during the first outbreak. The initial outbreak usually occurs within 2–20 days after infection and is often more severe than later recurrences. The virus remains in the body for life and can be reactivated during times of stress or weakened immune function (Cleveland Clinic, 2022).
How is herpes treated?
Although herpes cannot be cured, antiviral medications such as acyclovir, valacyclovir, and famciclovir can relieve symptoms and reduce the frequency of outbreaks. Antiviral therapy can be used in two ways:
- Temporarily during an outbreak, to relieve symptoms and shorten the duration of the episode.
- As long-term suppressive therapy, taken daily to reduce the frequency and severity of outbreaks.
The latter is especially recommended for individuals with more than six outbreaks per year. During an outbreak, it is important to avoid close physical contact to prevent the spread of the virus (Mayo Clinic, 2022).
What are the long-term consequences of herpes?
Untreated herpes can lead to repeated outbreaks of blisters and sores, causing long-term pain and emotional distress. Genital herpes increases the risk of contracting other sexually transmitted infections. In rare cases, complications such as meningitis (herpes encephalitis) or eye infections can occur (Mayo Clinic, 2022).
2 – Hepatitis B
Hepatitis B is a viral infection that affects the liver and can present as either an acute or long-term condition. In its acute phase, the infection may resolve within a few months. However, if the virus remains in the body, it can develop into chronic hepatitis B, which may lead to serious liver damage over time. An estimated 257 million people worldwide are infected with chronic hepatitis B (WHO, 2024).
How is hepatitis B transmitted?
- Contact with infected blood
- Unprotected sexual contact
- Sharing needles or syringes
- Mother-to-child transmission during childbirth
- Contact with open wounds or blood of infected individuals
- Transmission possible without visible symptoms
What are the main symptoms of hepatitis B?
In the early stages of the disease, symptoms often do not occur. Initial symptoms may include fatigue, loss of appetite, and nausea, while later symptoms can include jaundice (yellowing of the skin and eyes) and dark urine (Cleveland Clinic, 2022).
How is hepatitis B treated?
There is currently no cure for hepatitis B, but treatment aims to control the virus, prevent liver damage, and improve the quality of life for those affected. Antiviral medications such as tenofovir and entecavir are used for this purpose. People with chronic hepatitis B must be regularly monitored by healthcare providers to assess liver function and detect possible complications at an early stage.
How can hepatitis B be specifically prevented?
Vaccination against hepatitis B is the most effective preventive measure to avoid infection. In Germany and the Netherlands, the vaccine is routinely given to all infants and children, as well as to individuals in high-risk groups such as healthcare workers and people with increased risk of infection (Cleveland Clinic, 2022).
What are the long-term consequences of hepatitis B?
The long-term effects of hepatitis B include severe liver damage such as cirrhosis (in which healthy liver tissue is replaced by scar tissue due to chronic inflammation), liver cancer, and liver failure (NHS, 2022).
3 – HIV (Human Immunodeficiency Virus)
The human immunodeficiency virus (HIV) is a viral infection that damages cells essential for fighting off diseases and infections. Over time, the virus weakens or destroys the human immune system. If left untreated, HIV leads to AIDS (acquired immunodeficiency syndrome), and the 6-year survival rate after the onset of AIDS without proper treatment is only 18% (Poorolajal et al., 2016).
How is HIV transmitted?
- Contact with infected blood
- Unprotected sexual intercourse
- Sharing needles or syringes
- Mother-to-child transmission during childbirth or breastfeeding
- Blood transfusions with infected blood (rare in countries with strict blood screening)
- Transmission possible without visible symptoms
What are the main symptoms of HIV?
HIV infection can be divided into three stages, each with different symptoms depending on how far the virus has spread and how much it has damaged the immune system cells. Especially in the chronic phase, the virus can multiply for a long time without causing symptoms and may go undetected without regular testing.
| Stage | Symptoms | Timeframe |
|---|---|---|
| Acute HIV infection | No symptoms, fever, rash, swollen lymph nodes, sore throat | 2–6 weeks after infection |
| Chronic HIV infection | Often no symptoms, weight loss, fatigue, fever, fungal infections | Several years (up to 15) untreated |
| AIDS | Persistent, unexplained fatigue, chronic diarrhea, recurring infections | Varies, usually after several years without treatment |
Source: Mayo Clinic, 2024
How is HIV treated?
HIV is currently incurable, meaning the virus remains in the body for life. The goal of treatment is therefore to reduce the viral load in the blood and maintain immune system function as effectively as possible. Antiretroviral therapy (ART) helps to slow the virus's replication and strengthen the immune system. Patients must follow the treatment regimen strictly to prevent viral replication. With consistent medication use, the virus can be suppressed to such a low level that it is minimal or even undetectable in the blood, and the risk of transmission becomes virtually zero. Many people with HIV have a life expectancy similar to that of healthy individuals when the virus is well controlled (WHO, 2024).
How can HIV be specifically prevented?
Pre-exposure prophylaxis (PrEP) is a medication that can be beneficial for people at high risk of contracting HIV—for example, those with HIV-positive partners. When taken correctly every day, PrEP can reduce the risk of sexual transmission of HIV by up to 99% in HIV-negative individuals (CDC, 2022). In cases of suspected exposure, post-exposure prophylaxis (PEP) can be administered and must be taken within 72 hours of the incident. Note that PrEP does not protect against other STIs, so condom use is still recommended (NHS, 2024).
What are the long-term consequences of HIV?
Long-term consequences of HIV may include progressive immune system damage and the development of AIDS, which leads to increased vulnerability to infections and chronic inflammation. Additionally, HIV is associated with an increased risk of many cancers and cardiovascular diseases (Cleveland Clinic, 2022).
4 – HPV (Human papillomavirus)
The human papillomavirus (HPV) refers to a group of viruses that can cause infections of the skin and mucous membranes. These viruses are mainly transmitted through sexual contact and are among the most common sexually transmitted infections worldwide. HPV types are divided into low-risk HPV types, which cause genital warts, and high-risk HPV types (especially HPV 16 & 18), which can lead to various cancers such as cervical cancer. It is estimated that around 80% of sexually active people (men and women) worldwide will contract HPV at some point in their lives (Cleveland Clinic, 2023).
How is HPV transmitted?
- Skin-to-skin contact
- Vaginal, oral, and anal intercourse
- Transmission possible without visible symptoms
What are the main symptoms of HPV?
Many people do not develop symptoms, and the infection often clears up on its own. Low-risk HPV types can cause genital warts, which appear as small, flesh-colored or grey growths in the genital or anal area and may cause itching. High-risk HPV types may lead to abnormal Pap smear results (indicating potentially precancerous changes in the cervix), pelvic pain, and bleeding after intercourse or between periods. Other symptoms may include difficulty swallowing, persistent sore throat, and bleeding or discharge from the anus.
How is an HPV infection treated?
HPV is often incurable because the virus remains in the body. However, treatment depends on the type of HPV. For low-risk HPV types that cause genital warts, the warts can be removed with topical treatments, freezing, or minor surgical procedures. In Germany, women with public health insurance between the ages of 20 and 34 are entitled to a free annual Pap smear. If abnormalities are detected, the affected tissue can be removed to prevent the development of cancer (Mayo Clinic, 2023; Cleveland Clinic, 2023).
How can HPV be specifically prevented?
The HPV vaccine is recommended for children aged 11–12 and can prevent more than 90% of HPV-related cancers. Although the vaccine is recommended at this age, it can also be given to older individuals who are already sexually active. There are different types of HPV vaccines that protect against various virus strains. Condoms can reduce the risk but do not completely prevent transmission (NHS, 2023).
What are the long-term consequences of HPV?
If left untreated, HPV can lead to several types of cancer, including cervical cancer (all cases caused by HPV), anal cancer (over 90% of cases caused by HPV), and cancers of the mouth and throat (NIH, 2024).
How can you protect yourself against STIs?
Preventive measures may vary depending on the specific sexually transmitted infection, but there are several general rules that significantly reduce the risk of transmission. Here are the most important ones:
- Use condoms and barrier methods: Wearing condoms and other barrier methods correctly, such as dental dams, can significantly reduce the risk of transmitting sexually transmitted diseases.
- Educate yourself about STIs: Understanding the symptoms, transmission routes, and prevention strategies of STIs helps promote responsible behavior and can prevent infection and spread.
- Get tested regularly: Regular STI testing helps detect and treat infections early, protecting both your health and the health of your sexual partners.
- Avoid alcohol and drug use before sex: Alcohol and drugs can impair judgment and increase the likelihood of having unprotected sex.
- Open communication with sexual partners: Talk to your partners about sexual health and STI test results. Honest communication builds mutual trust and lowers the risk of STI transmission.
- Get vaccinated if possible: Vaccines against HPV and hepatitis B can protect against these specific STIs. Ask your doctor about available vaccines.
Source: WHO, 2024
Another important point that should not be overlooked: Of course, everyone is free to live out their own sexuality, but having many changing sexual partners significantly increases the risk of infection. In this context, regular STI testing is essential. Unfortunately, shame is often the biggest obstacle to an open and conscious approach to sexual health—but don't hesitate to take proactive steps to protect yourself and your partner.
Summary
The incurable sexually transmitted infections (STIs) include herpes, hepatitis B, HIV, and HPV. These infections remain in the body for life and in some cases require lifelong treatment to keep the virus under control. The most important preventive measures include using condoms and barrier methods, getting tested regularly, getting vaccinated against HPV and hepatitis B, and maintaining open communication with sexual partners. Additionally, avoiding alcohol and drug use before sex is important for making clearer decisions regarding safer sex.
